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Spike in Abuse of Stimulants Like Adderall, Ritalin Nationwide

Article in the Saratogian news (www.saratogian.com) titled, "Spike in abuse of stimulants like Adderall, Ritalin nationwide packs ERs with students" written in January 2013

Emergency-room visits for misuse of hyperactivity drugs such as Adderall and Ritalin have more than doubled in five years, with young adult abuse growing even faster, according to a new federal report.

Abuse among young adults can be traced, in part, to misuse by 18- to 25-year-olds using drugs for all-night study sessions, for staying conscious longer so they can drink more, and for weight loss.

"You would be absolutely floored by the abuse of Adderall among college students," said Patrick Iversen, a student at Columbia College in Missouri who has had ADHD since age 5. "I've seen it passed around so much. For them, it's like caffeine."

ER visits whose listed reasons included an ADHD stimulant rose from 13,379 in 2005 to 31,244 just five years later, according to the Substance Abuse & Mental Health Services Administration. ER visits by those 18-25 nearly quadrupled in that time, to 8,148.

The portion of those visits caused by non-prescribed use of the stimulants rose to half.

Even the numbers seeking the stimulants with a legitimate prescription are worrisome, because so many students are walking into campus health centers for an instant "diagnosis" before finals or some other cram session, said Dr. Donald Misch, assistant vice chancellor for health and wellness at the University of Colorado at Boulder. He said ADHD drugs are available behind "every second or third" dorm door.

Students think, "Your eyes aren't good, you get glasses; if your brain isn't working as well as it should be, why shouldn't I use a stimulant?" Misch said.

Former addict Kate Beach knows why: Students may end up addicted and maxing out their parents' credit cards to pill shop.

Beach, a University of Kansas graduate from Colorado Springs, had an ADHD diagnosis at age 18. The drugs helped her focus and succeed at school, but by age 22, she was taking five times the recommended dose and shuffling prescriptions in three states.

After years of hard work to get clean, Beach, 26, works at the admissions desk of CeDAR, the University of Colorado Health rehabilitation center, and is on a nonstimulant medication.

ER visits include a fast heartbeat, shortness of breath, agitation and anxiety, as with other stimulants like cocaine, said Dr. Homi Kapadia , an ER doctor with Exempla Lutheran.

The U.S. study shows 63 percent of ER visits involving the stimulants included use of another substance -- with anti-anxiety and sleep medications, painkillers and alcohol highest among those.

People abusing them at parties may snort the powder to get a faster "high" than through the stomach. The stimulants can keep users from passing out during binge drinking, and studies have shown that those who combine stimulants with alcohol drink 83 percent more, Misch said.

As for the "smart pill" argument, said CeDAR director Steven Millette , "there may be a period when it does work, but as the problem progresses, you are in a more dysfunctional relationship with the drug."

Physicians who prescribe the stimulants need to make a valid diagnosis of attention deficit and follow up with patients to monitor use, Millette said.

CU-Boulder has not implemented hard and fast rules about prescribing the stimulants. "ADHD is on a continuum," Misch said.

"We feel better" when students can give a childhood history, a medical record or a family history related to the attention disorder, he said.

One message to parents, he added: "If your kids are using stimulants because they haven't been studying all week and it's Sunday night, that's not something I want to reinforce."

He also warns patients that they're starting a relationship to medication that will continue after school.

"Life," he said, "doesn't necessarily get easier."